Organization
THE GROVE DENTAL GP
Active
Other names
The Grove Dental GP
Organization subpart
No
Provider details
NPI number
Authorized official
MICHASEL JACOB BRATLAND DMD (OWNER)
(541) 643-6772
Entity
Organization
Contact information
Practice address
1235 NE 6TH ST, GRANTS PASS, OR 97526-1286
(541) 492-1687
(541) 418-4311
Mailing address
PO BOX 1541, ROSEBURG, OR 97470-0360
(541) 492-1687
(541) 418-4311
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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